Perforator artery response to tissue expansion: An experimental study in rabbits

Adv Clin Exp Med. 2019 Sep;28(9):1153-1159. doi: 10.17219/acem/104530.

Abstract

Background: The reconstruction of defects is a major area of interest in plastic surgery. Tissues are expanded to extend the tissue surface area and to prepare more reliable perforator flaps.

Objectives: Because expanded perforator flaps have become more popular, the aim of this study is to determine the response of the perforator artery to tissue expansion.

Material and methods: We used a rabbit S1 perforator (first perforator branch of the thoracodorsal arteries) flap model. In 12 New Zealand White rabbits, left flaps were used as the experimental group (n = 12) and right flaps were used as the control group (n = 12). Both flaps were constructed in the dorsal skin. The experimental group was further divided into 3 subgroups according to expansion volume: 150 mL (n = 4), 200 mL (n = 4) and 250 mL (n = 4). We evaluated the responses of the perforator arteries to tissue expansion using the resistivity index (RI), the pulsatility index (PI), vessel diameter (D), histopathological examinations, and angiography.

Results: After 3 weeks of expansion, the perforator artery diameter had increased (p = 0.002) and the RI had decreased (p = 0.031) in the experimental group. The perforator artery diameter (p = 0.006) and RI had increased (p = 0.003) in the control group. No significant changes were observed in the PI in either group (p > 0.05) and no significant differences in post-expansion measurements were observed between experimental subgroups (p > 0.05).

Conclusions: Suprafascial expansion of a perforator flap leads to an increase in diameter and a decrease in the RI of the perforator artery. The decrease in RI may indicate increased flap perfusion.

Keywords: Doppler indices; experimental; perforator artery; rabbit; tissue expansion.

MeSH terms

  • Angiography
  • Animals
  • Arteries
  • Perforator Flap* / blood supply
  • Plastic Surgery Procedures* / methods
  • Rabbits
  • Tissue Expansion